NYAPRS Note: This article identifies two priority areas that require advocacy and education from our community: national laws that criminalize persons for seeking mental health treatment, and the invasion of privacy of those persons due to supposed security measures.

Shameful Profiling of the Mentally Ill

New York Times; Andrew Solomon, 12/7/2013

A CANADIAN woman was denied entry to the United States last month because she had been hospitalized for depression in 2012. Ellen Richardson could not visit, she was told, unless she obtained “medical clearance” from one of three Toronto doctors approved by the Department of Homeland Security. Endorsement by her own psychiatrist, which she could presumably have obtained more efficiently, “would not suffice.” She had been en route to New York, where she had intended to board a cruise to the Caribbean.

“I was so aghast,” Ms. Richardson told a Toronto Star reporter. “I don’t understand this. What is the problem?’ I was so looking forward to getting away. I’d even brought a little string of Christmas lights I was going to string up in the cabin.”

The border agent told her he was acting in accordance with the United States Immigration and Nationality Act, Section 212, which allows patrols to block people from visiting the United States if they have a physical or mental disorder that threatens anyone’s “property, safety or welfare.” The Star reported that the agent produced a signed document stating that Ms. Richardson would need a medical evaluation because of her “mental illness episode.” A spokeswoman for United States Customs and Border Protection told the Star that the agency was prohibited from discussing specific cases because of privacy laws.

This is not the first time such measures have been reported. In 2011, Lois Kamenitz, a Canadian and a former teacher, was barred from entering the United States because she had once attempted suicide. Ryan Fritsch, former co-chairman of the Ontario Mental Health Police Record Check Coalition, told the Star that he had heard of eight similar cases that year. After the incident, he wrote to me: “My sense is that there are a great many people being turned away. I’ve also heard of executive-level reps from various Canadian and provincial mental health advocacy and awareness organizations being turned away at the border on their way to conferences and other official functions and appearances,” presumably because of their own medical histories.

Ms. Richardson’s health information should never have been available to United States authorities, and many Canadians are outraged at the thought that their government may have divulged it. It’s not clear at this point, however, what the customs agent saw.

Her ruined vacation could have been a result of his access to law enforcement databases. Ms. Richardson explained to me that when she was hospitalized in June 2012, the police were involved because she had made a suicide attempt that led to a 911 call. But even if it is police data rather than medical data that has been shared, the use by immigration authorities remains troubling.

Much more troubling, however, is the notion that information about a person’s depression, no matter how legitimately obtained, might have any bearing on her ability to visit the United States.

People in treatment for mental illnesses do not have a higher rate of violence than people without mental illnesses. Furthermore, depression affects one in 10 American adults, according to estimates from the Centers for Disease Control and Prevention. Pillorying depression is regressive, a swoop back into a period when any sign of mental illness was the basis for social exclusion.

The Americans With Disabilities Act of 1990 prevents employers from discriminating against people who have a mental illness. If we defend the right of people with depression to work anywhere, shouldn’t we defend their right to enter the country? Enshrining prejudice in any part of society enables it in others. Most of the people who fought for the right of gay people to serve in the military did so not because they hoped to become gay soldiers themselves, but because any program of government-sanctioned prejudice undermined the dignity of all gay people. Similarly, this border policy is not only unfair to visitors, but also constitutes an affront to the millions of Americans who are grappling with mental-health challenges.

Stigmatizing the condition is bad; stigmatizing the treatment is even worse. People who have received help are much more likely to be in control of their demons than those who have not. Yet this incident will serve only to warn people against seeking treatment for mental illness. If we scare others off therapy lest it later be held against them, we are encouraging denial, medical noncompliance and subterfuge, thereby building not a healthier society but a sicker one.

We have already seen such a situation: For more than 20 years the United States prohibited people with H.I.V. from entering the country. We were one of a very few countries to take this bigoted stand. An activist lobby fought against the ban, which was finally lifted in 2009. President Obama expressed his belief that the ban had led to bias against people with H.I.V., which discouraged people from getting tested.

Ms. Richardson, who attempted suicide in 2001 and as a result is paraplegic, has asserted that she has had appropriate treatment, and that she now has a fulfilling, purposeful life. We should applaud people who get treatment and manage to live deeply despite their challenges. It is both humane and in our self-interest to ensure that as many people as possible avail themselves, without governmental disapprobation, of the array of supports that may help them. The president needs to speak out against Section 212 as he did against the H.I.V. ban and to put to rest the idea that people with mental health conditions who pose no danger are unwelcome in our country.